title: Dermatology life quality index and side effects after topical photodynamic therapy of actinic keratosis.
abstract: BACKGROUND
  Photodynamic therapy (PDT) is an excellent treatment option for actinic keratosis. However the side effects lead to an impairment of the patients' quality of life.
  
  
  OBJECTIVE
  To evaluate the impact of PDT on patients' quality of life and to determine the frequency and intensity of side effects over the course of 4 weeks post PDT.
  
  
  METHODS
  22 patients with actinic keratosis in the face were included into this prospective study. Pain was measured using a visual analog scale immediately and 8 h after PDT. The Dermatology Life Quality Index (DLQI) was assessed at screening, after treatment as well as 2 and 4 weeks after PDT. The physician and patient evaluated the intensity of side effects during the treatment, 2 and 4 weeks post PDT. Additionally, the patient documented side effects daily from the 1st to the 14th day after PDT and on day 28 post PDT, using a diary.
  
  
  RESULTS
  We observed a significant (p < 0.001) increase in the DLQI from 1.6 ± 1.7 prior to PDT to 7.3 ± 4.9 post PDT. The DLQI normalized in the following 4 weeks. Immediately and 8 h after PDT mean pain was 4.3 ± 2.5 and 2.3 ± 2.1. Side effects documented by the patients were erythema (100%), pain, burning, edema (90.9%), itching (86.4%), scaling (81.8%) and pustules (59.1%). No scar formation, hyper-/hypopigmentation or infections were observed.
  
  
  CONCLUSIONS
  PDT has a significant temporary impact on patients' DLQI. Transitory side effects are common and show typical kinetics.
authors.affiliation: Department of Dermatology, University of Heidelberg, Heidelberg, Germany. patrick.gholam@med.uni-heidelberg.de
authors.forename: Patrick
authors.initials: P
authors.lastname: Gholam
authors.forename: Verena
authors.initials: V
authors.lastname: Kroehl
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Enk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000627:therapeutic use*; D004487:Edema / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005148:Facial Dermatoses / Q000188:drug therapy*; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011537:Pruritus / Q000209:etiology; D011788:Quality of Life; D013997:Time Factors
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid